milnacipran, Savella

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

GENERIC NAME: milnacipran

BRAND NAME: Savella

DRUG CLASS AND MECHANISM: Milnacipran is a selective serotonin and
norepinephrine reuptake inhibitor (SNRI) used for treating pain associated with
fibromyalgia.
It is similar to
duloxetine (Cymbalta),
venlafaxine
(Effexor), and
desvenlafaxine (Pristiq). Milnacipran affects neurotransmitters, the
chemicals that nerves within the brain make and release in order to communicate
with one another. Neurotransmitters either travel across the space between
nerves, attach to receptors on the surface of nearby nerves or they attach to
receptors on the surface of the nerves that produced them. The neurotransmitters
may be taken up by the nerve and released again (a process referred to as
re-uptake).

Serotonin and norepinephrine are two neurotransmitters released by nerves in
the brain. Milnacipran prevents the reuptake of serotonin and epinephrine by
nerves after they have been released. Since uptake is an important mechanism for
removing released neurotransmitters and terminating their actions on adjacent
nerves, the reduced uptake caused by milnacipran increases the effect of
serotonin and norepinephrine in the brain. The mechanism responsible for its
effectiveness for treating fibromyalgia is not known but milnacipran action is
thought to involve its effects on serotonin and norepinephrine in the brain.
Milnacipran was approved by the FDA in January 2009.